Individual
MRS. SUSAN MARIE MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1635 OHIO ST, WATERTOWN, NY 13601-3032
(315) 786-7285
Mailing address
28273 ROCKLEDGE DR, CHAUMONT, NY 13622-0533
(781) 581-1852
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
033802-1
NY
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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